16排CT在胆囊炎结石中的临床诊断价值
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摘要
目的探讨16排CT运用于胆囊炎结石临床诊断中的价值。方法临床纳入本院2016年1月～2018年1月期间收治的90例胆囊炎结石患者作为研究对象,将全部入选者随机分为研究组、对照组,均为45例。对照组患者常规进行超声检查,研究组采用16排螺旋CT进行检查,并将两组胆囊炎结石检出率、直径超过0.7cm肝外胆总管结石检出率进行对比。另外,将两组不同分型胆囊炎结石检出率进行对比。结果研究组胆囊炎结石检出率较对照组明显更高,分别为95.56%、80.00%,差异有统计学意义(P <0.05);研究组直径超过0.7cm肝外胆总管结石检出率为64.44%,明显高于对照组的33.33%,差异有统计学意义(P <0.05);研究组与对照组胆囊结石、胆总管结石、肝内胆管结石、肝外胆管结石检出率差异无统计学意义(P>0.05)。结论 16排CT在临床早期诊断胆囊炎结石上具有明显优势,有利于进一步提升胆囊炎临床检出率,避免漏诊、误诊情况发生,为疾病的定性提供有价值参考,是一种理想的诊断方式,具备较高临床运用价值。
Objective To explore the clinical diagnosis value of 16 slice CT in cholecystitis stones. Methods Ninety cases with cholecystitis stones admitted to the hospital from January 2016 to January 2018 were selected,and randomly divided into the study group and the control group,each had 45 cases.The control group was examined by conventional ultrasound,the study group was examined by 16 slice spiral CT.Cholecystitis stones detection rate,diameter of more than 0.7 cm extrahepatic bile duct stones detection rate were compared between the two groups.In addition,the detection rate of different types of cholecystitis stones in the two groups were compared. Results The detection rate of cholecystitis stones in the study group was significantly higher than the control group,95.56% and 80.00% respectively,and the difference was statistically significant(P < 0.05).The diameter of more than 0.7 cm extrahepatic bile duct stones detection rate in the study group was 64.44%,which was significantly higher than 33.33% in the control group,the difference was statistically significant(P < 0.05).There was no significant difference in the detection rate of gallbladder stones,choledocholithiasis,intrahepatic bile duct stones and extrahepatic bile duct stones between the study group and the control group(P > 0.05). Conclusion 16 slice CT has obvious advantages in early diagnosis of cholecystitis stones,which is conducive to further improve the clinical detection rate of cholecystitis,avoid missed diagnosis and misdiagnosis,and provide valuable reference for disease identification.It is an ideal diagnosis method and has a high clinical value.
Objective To explore the clinical diagnosis value of 16 slice CT in cholecystitis stones. Methods Ninety cases with cholecystitis stones admitted to the hospital from January 2016 to January 2018 were selected,and randomly divided into the study group and the control group,each had 45 cases.The control group was examined by conventional ultrasound,the study group was examined by 16 slice spiral CT.Cholecystitis stones detection rate,diameter of more than 0.7 cm extrahepatic bile duct stones detection rate were compared between the two groups.In addition,the detection rate of different types of cholecystitis stones in the two groups were compared. Results The detection rate of cholecystitis stones in the study group was significantly higher than the control group,95.56% and 80.00% respectively,and the difference was statistically significant(P < 0.05).The diameter of more than 0.7 cm extrahepatic bile duct stones detection rate in the study group was 64.44%,which was significantly higher than 33.33% in the control group,the difference was statistically significant(P < 0.05).There was no significant difference in the detection rate of gallbladder stones,choledocholithiasis,intrahepatic bile duct stones and extrahepatic bile duct stones between the study group and the control group(P > 0.05). Conclusion 16 slice CT has obvious advantages in early diagnosis of cholecystitis stones,which is conducive to further improve the clinical detection rate of cholecystitis,avoid missed diagnosis and misdiagnosis,and provide valuable reference for disease identification.It is an ideal diagnosis method and has a high clinical value.
引文
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[9]张伟荣,唐艳青,江金菊,等.护理标准化诊断在急性胆囊结石术后患者中的应用[J].护理实践与研究,2017,14(12):62-64.
[10]Horn Torben,Christensen Sara D,Kirkegard Jakob,et al.Percutaneous cholecystostomy is an effective treatment option for acute calculous cholecystitis:a 10-year experience[J].HPB:the official journal of the International Hepato Pancreato Biliary Association,2015,17(4):326-331.
[11]王建良,朱玉春,邢伟,等.黄色肉芽肿性胆囊炎与厚壁型胆囊癌的螺旋CT鉴别诊断[J].临床放射学杂志,2015,34(1):74-78.
[12]张志强.坏疽性胆囊炎发生的危险因素分析[J].肝胆胰外科杂志,2016,28(4):278-281.
[13]张建英,蒋瑾,母其文,等.黄色肉芽肿性胆囊炎的CT诊断价值与误诊分析[J].西部医学,2017,29(4):543-545,550.
[14]王蔚蓝,孙海明.黄色肉芽肿性胆囊炎45例诊治分析[J].肝胆胰外科杂志,2015,27(1):74-75.
[15]张育森,朱德君,陈阳,等.急性化脓坏疽性胆囊炎的判别分析[J].中华普通外科杂志,2016,31(11):914-916.
[2]樊新咏,温燕芳.腹腔镜手术对结石性胆囊炎的临床疗效分析[J].现代诊断与治疗,2017,28(20):3758-3759.
[3]马瑞斌,徐彦辉,柯颖,等.腹腔镜胆囊切除术与小切口胆囊切除术治疗老年胆囊结石的疗效比较[J].中国现代医生,2015,53(4):36-38.
[4]Fagenholz Peter J,Fuentes Eva,Kaafarani Haytham,et al.Computed Tomography Is More Sensitive than Ultrasound for the Diagnosis of Acute Cholecystitis[J].Surgical infections,2015,16(5):509-512.
[5]王均庆,陆风旗,张雷等.多排螺旋CT后处理技术在胆源性胆囊-十二指肠瘘诊断中的应用[J].中华肝胆外科杂志,2015,21(12):798-801.
[6]RegimbeauJM,FuksD,PautratK,etal.Effect of postoperative antibiotic administration on postoperative infection following cholecystectomy for acute calculous cholecystitis:A randomized clinical trial[J].JAMA:the Journal of the American Medical Association,2014,312(2):145-154.
[7]李华.胆囊癌的临床特点及CT影像诊断分析[J].国际医药卫生导报,2016,22(14):2161-2163,2166.
[8]李永杰,周耿,方孟园,等.肝功能指标在诊断胆囊结石合并无症状胆总管结石中的作用[J].中华肝胆外科杂志,2014,20(6):431-434.
[9]张伟荣,唐艳青,江金菊,等.护理标准化诊断在急性胆囊结石术后患者中的应用[J].护理实践与研究,2017,14(12):62-64.
[10]Horn Torben,Christensen Sara D,Kirkegard Jakob,et al.Percutaneous cholecystostomy is an effective treatment option for acute calculous cholecystitis:a 10-year experience[J].HPB:the official journal of the International Hepato Pancreato Biliary Association,2015,17(4):326-331.
[11]王建良,朱玉春,邢伟,等.黄色肉芽肿性胆囊炎与厚壁型胆囊癌的螺旋CT鉴别诊断[J].临床放射学杂志,2015,34(1):74-78.
[12]张志强.坏疽性胆囊炎发生的危险因素分析[J].肝胆胰外科杂志,2016,28(4):278-281.
[13]张建英,蒋瑾,母其文,等.黄色肉芽肿性胆囊炎的CT诊断价值与误诊分析[J].西部医学,2017,29(4):543-545,550.
[14]王蔚蓝,孙海明.黄色肉芽肿性胆囊炎45例诊治分析[J].肝胆胰外科杂志,2015,27(1):74-75.
[15]张育森,朱德君,陈阳,等.急性化脓坏疽性胆囊炎的判别分析[J].中华普通外科杂志,2016,31(11):914-916.